Diabetes Care and Treatment

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Hypoglycemic Research Articles

Hypoglycemia is a most common, potentially avoidable consequence of diabetes treatment and is a major barrier to initiating or intensifying anti-hyperglycemic therapy in efforts to achieve better glycemic control. Therapy regimen and a history of hypoglycemia are the most important predictors of future events.

The other adverse effects include renal insufficiency, older age, and history of hypoglycemia-associated autonomic failure. Reported rates of hypoglycemia may vary considerably among studies because of differences in study design, definitions used, and population included, among other factors. Although occurring more frequently in type 1 diabetes, hypoglycemia also is clinically important in type 2 diabetes. Symptoms experienced by patients may vary among individuals, and many events remain undiagnosed. The incidence of severe events is unevenly distributed, with only a small proportion (∼5%) of individuals accounting for >50% of events.

Clinicians also need to be diligent in collecting detailed patient records, since a clear description of the incidence and extent of hypoglycemic events is important for effective diabetes management. The extreme hypoglycemia is associated with an increased risk of death of individuals, loss of cognitive function, and negative effects on the quality of life of patients.

Economically, hypoglycemia burdens the healthcare system and adversely affects workplace productivity, particularly after a nocturnal event. On-going healthcare reform efforts will result in even more emphasis on reducing this adverse effect of diabetes treatment. Therefore, improving patients' self-management skills and selecting or modifying therapy to reduce the risk of hypoglycemia will increase in importance for clinicians and patients alike.

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